is it really psoriasis?

[wendy-o]

Long and complicated story. My son at age 13, following 2 Hep B vaccs developed psoriasis over 90% of his body. Drs were never alarmed, it's psoriasis, a genetic condition, sucks to be him but what can you do? Over the years we've tried creams, ointments, light therapy, nothing has helped. Last year at age 17 he developed hobbling psoriatic arthritis. Took him to a rheumatologist, it's PA, a genetic condition, sucks to be him but what can you do? They did want to put him on Methx but my son refused. (thank god)

Over the years I've done tons of research, it doesn't make sense that this strong healthy kid's body suddenly decided to "attack itself" (the autoimmune theory). We have absolutely no history of psoriasis in our family (genetic theory). It also didn't make sense that the symptoms kept jumping around, one week this ankle would hurt, the next week, the other one. His back would be sore, then his ribs. I was a clinical microbiologist many years ago and can recognize a "stealth" infection when I see one. My son has classic symptoms of a syphilis infection. (he is neg).

Based on a recc from a friend I took him to another Dr who tested my son and guess what? He's positive for Lyme disease. (we live in a wooded area in New Hampshire). All of his symptoms (skin, arthritis, fatigue, insomnia, etc.) can be explained by Lyme. He was brought in for a red round rash 6 years ago but the Drs felt it was yeast and sent him home with a cream.

He is currently going on his 3rd week of antibiotics (and will probably be taking them for months if not years) and ALL of his psoriasis symptoms are flaring. There is not an antibiotic on the face of the face of the earth that has those side effects however, there is a bacteria (Lyme) which during a die off from the antibiotics could account for every single symptom.

So does my son have just Lyme which has caused all of his symptoms or does he have Lyme in addition to psoriasis? Who knows, it's far too early to tell. Just thought I'd start his story here and update as appropriate.

[arizona]

On reading this i googled lymes and was rather alarmed at my findings.

I also have no history in family of p

Since starting this ten years ago after what was diagnosed as shingles, stiff neck, rash etc, i am photophobic to the point of a dicky strip light in a shop can give me instant sickness and migraine with numbness to limbs, tongue, face.

Six years ago i was admitted to hospital with meningitis and encephalitis

Memory problems and lack of concentration since have been put down to that

I wonder if there is a link here?

[wendy-o]

At this point, I can't say that all of my son's symptoms are because of Lyme but one thing that really pushed me to make the make the apt with the Lyme Dr. was watching the documentary "Under our Skin". Many of the symptoms listed for Lyme (numbness, tingling, headaches, slight tremors or muscle twitching) are also present in my son. Why would an "increased skin production condition" have all those other symptoms?

And yet, none of his Drs wanted to do any investigating. They saw his skin, they saw the flakes and stopped everything right there. When they diagnosed him with psoriasis they gave up on him. 

[arizona]

Is he currently under care of a dermatologist? Perhaps some light treatment would go someway to helping with the skin at the moment?

[wendy-o]

We live in the northeastern part of the US, he has spent the entire summer outside in the sun near a pool (he babysits for a family). We've also gone a few times to the shore and like many people have reported, salt water helps his skin (salt also kills bacteria - is the skin getting temporarily better because of the anti-bacterial properties of salt?)

The summer is typically when he does the best with regard to his skin (although it has never completely cleared up for the last 5 years) and joint pain which is why a flare at this time of year is so interesting. His flare happened after the introduction of antibiotics, nothing else, just plain old antibiotics. I'm willing to admit that there may be a genetic link to this in that his skin is his weak spot when attacked much like my lungs are my weak spot when I get a cold, I get a chest cold, my husband always gets a sinus cold but I'm not convinced that the genetics are *causing* the symptoms as much as they are *allowing* the symptoms.

As I said, its far too early to make any sort of conclusions and it may be that his flare is just a co-incidence (I don't think so but I'm willing to accept that that is a possibility). Only time will tell but if (and I know this is a HUGE if) his symptoms clear up *just* from being on antibiotics (as opposed to the extremely expensive medications they have proposed for his future) just think of what that could mean for others who may also be mis-diagnosed as having something other than Lyme.

Qualifier, I'm not saying that all Psoriasis is Lyme, I'm simply hypothesizing that my son's psoriasis and psoriatic arthritis *may* instead be Lyme. I've seen the heart-break, pain and misery of psoriasis in my son and I am in no way trying to say anything other than we seem to have something interesting going on here.

[wendy-o]

Just as an update to this thread. My son has been on the Lyme antibiotics for about 3 weeks now. (and boy did they make him sick, sick, sick, for a few days.)

His blood work shows that he has a chronic Lyme infection (as near as we can put the pieces together, he probably got it 6 years ago).

At his latest appointment the Dr. also put him on anti-yeast meds for a case of oral thrush (he had this prior to the antibiotics.) The first 3 days of the anti-yeast were not pleasant, lots of reactions. Dr. also put him on a few supplements (Vit D, Fish oil, Sam-e, probiotics)

For the first time in 3 years we are seeing *some* clearing of his condition. One arm is almost completely cleared (roughly 50% had been covered, it's probably down to 10%) and his other arm shows improvement. What's unusual is that in the first year when he showed symptoms, when some (never all) of the initial spots did go away, they left a white area in his skin. This time they are leaving a darker area behind (hyper, not hypo). Just interesting, that's all.

His lower legs (where he has large, thick patches) although not as red as before are roughly the same size and don't show improvement, however, the smaller satellite spots are definitely clearing up. His belly, back, and thighs are also showing *some* improvement, scalp (including large forehead patch), however, is still fully involved.

His joint symptoms have not changed.

Still, for the first time in several years, we seem to be moving forward.

He left for college this morning and I won't be seeing him again until November.

The plan is to keep him on antibiotics for several months (if not years), it all depends on symptoms (I know of several local people positive with Lyme who have been taking antibiotics for at least 2.5 years now)

Not suggesting anyone take this path, just reporting what we are finding.

[leamarieuk]

I have no medical education at all, this is just my opinion.

If your son is positive for lymes disease, could this not of caused a flare up of psoriasis?
For a lot of psoriasis suffers their first flare up is caused by illness, often strep throat. I dont see how a doctor could mistake psoriasis for lymes as, in the pics I have seen, they look totally different. Where you say your sons smaller patches are clearing but not the larger patches, this is possibly due to being different types of psoriasis. The smaller dot like patches are possibly guttate p and the larger patches could be plaque p, both of which would react differently to the same treatment.


There is every possibility that you can have more than one condition at a time. I also have no family history of anyone with psoriasis, but there is no doubt that it is what I have suffered with for the past 15 years, and after x-rays and mri scans there is also no doubt I have PA. There may be a family member who has the psoriasis gene but has not had it 'triggered' so have never had any symptoms of psoriasis.

As for the joint pain, yes you can have flare ups in different joints at different times, so not all PA affected joints will necessarily hurt at the same time.

I really hope your son gets some relief

[wendy-o]

You bring up some valid points to which I have no definitive answers.

It could be that the infection is just there and has nothing to do with his psoriasis and that we just happened to discover the infection along the way. You remove the infection and he still has psoriasis but now his body is not fighting that infection and some of the freed up energy can now go to repairing some of the psoriasis. (could explain why we are seeing some clearing)

But it could also be just as likely that if you remove the infection, you remove how he reacts to the infection (psoriasis). If that were the case then the psoriasis symptoms may completely go away. (he has damage in his joints, I don't think that will go away but if this scenario is right then at least they wouldn't get any worse). That's my working theory based on the fact that we have seen progress for the first time in years based only on his taking antibiotics and I'm also using anecdotal stories of local people (Northeast US) with severe and Chronic Lyme who have had joint and skin symptoms that have cleared up after long term antibiotic therapy (several months to years)

If it turns out to be this, when he was cleared of the psoriasis symptoms, then if he were exposed to Lyme again he would show symptoms. Science has shown that there is a genetic marker associated with psoriasis - psoriatic symptoms might be how his unique body handles this infection. With re-infection, the symptoms would return. He would have to be careful about tick bites for the rest of his life. (we live in a heavily wooded area so it's not as easy as it might sound.)

It is also possible that all along he's been mis-diagnosed. 10 Doctors have diagnosed him with psoriasis but there is a chance that what they saw as psoriasis and psoriatic arthritis was really just symptoms of an infection (highly unlikely, he's been to several specialists,  but I suppose it could have happened). This could explain why a clearing could take place with the administering of antibiotics.

Only time will tell. Again he's off at college and I won't see him until November. He must be feeling better though, he's sent word for me to send his sneakers as he's joined the triathlon club - early in the spring, he had to walk with a cane and a foot brace because his ankle joint was so painful.

Interestingly enough, one of my other sons will be going in to be tested for Lyme (eventually all 6 kids will be tested). He has "brain fog" (distracted, difficulty remembering things) and he has tremendous fatigue which are both symptoms of Lyme (and yes, they are also symptoms of being a teenage boy). He also has some joint pain but as he is a competitive gymnast on the national level, well, who wouldn't have joint problems. If he does have it, however, he clearly has a different genetic make-up for the symptoms to display in this way.

[Scruff]

While p does run in families, you can get it without there being history there. Plus, how often do people remember if some distant relation had p? My mum and her brother have p, their two other brothers don't. I have p but my three other siblings don't. Neither of my grandparents, or any of their siblings have p, as far as we know, so where did it come from? I think you can be more prone than some to get p, and just need it to be triggered. I hope your sons' skin gets better soon.

Scruff

[wendy-o]

I know that I haven't updated this topic in a long time. My son, who had previously been diagnosed with psoriasis and psoriatic arthritis is currently under treatment for Lyme disease. It turned out he's got a few co-infections. (at least 2 along with the Lyme) We live in a very wooded area in New Hampshire US.

His RX is very large doses of 3 different antibiotics and probiotics (he's already had one yeast infection from not taking the probiotics)

Starting Meds right before he left for college was tough as he actually got worse (it's called a herx reaction). Being a kid, he decided to take the meds (antibiotics and supplements) only when he felt like it. Still we saw some results.

His skin looks the best it's looked in 3 years. This kid has NEVER gone into remission with his psoriasis and his arm which was solidly covered with patches in August in now covered at about 5% and the skin actually looks healthy (the non-patched skin used to have large red bumps all over it - now it looks normal). His stomach and back still have several patches but they are not inflamed and are getting much smaller. We had not seen any clearing of his forehead (it was a solid large "bar" of a patch) in at least 3 years but it is actually showing healthy skin growth in the top corners of the bar and is getting smaller.

His scalp psoriasis although getting slowly better is still bad, but his ears are no longer bloody and are showing signs of healthy skin growth and he seems to be improving from the top down (the skin on the top of his head is healthy with no patches at all). He's had a large patch over one eyebrow that is getting smaller and the patches that had been around his neck have gotten smaller or gone away. He did get a small patch on an eyelid but that has gone. (this is without any creams or even skin moisturizers - he doesn't like to use any creams). His leg smaller leg patches have decreased but he still has some severe ones on his shins.

Because he was completely off his meds when  he came home for Thanksgiving, (blood work showed us that the Lyme was increasing) we forced him over Christmas break to take his 3 antibiotics on a regular schedule. He had a new severe arthritic flare in his toe and right finger (herx reaction again) but he stuck it out. I talked to him last night and both flares are improving. (the last finger flare lasted for years and didn't respond to anything - PT, steroids, anti-inflamms)

In our case it appears that my son't psoriasis was a reaction to his severe infection with Lyme disease. Now that he understands how important it is to take the meds, he is back on schedule and I should have another update for you when he comes home on Spring break.

I'm sharing this information because I think its important to pass on. We came very close to putting our son on what would have been the wrong meds (steroids, methyltrex, and others) for a disease it appears he never had. Although it looked like he had psoriasis (and 10 Doctors agreed) it was only when we took him to a Lyme Literate Doctor who thought that maybe, just maybe, this was a reaction of his body fighting something else, that we found our answer.